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Hypertension: current management strategies

J Sutherland1, C Castle, R Friedman

  • 1Waterloo Family Practice Residency Program, IA 50702.

The Journal of the American Board of Family Practice
|May 1, 1994
PubMed
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Effective hypertension management, including lifestyle changes and medications, can reduce patient mortality. However, many cases remain undiagnosed or inadequately controlled, highlighting the need for improved adherence and risk factor management.

Area of Science:

  • Cardiology
  • Public Health
  • Pharmacology

Background:

  • Hypertension impacts 50 million Americans, being a leading cause for medical visits and prescriptions.
  • This review addresses the epidemiology, diagnosis, and treatment of hypertension, focusing on risk factors and adherence.
  • The Fifth Report of the Joint National Committee (JNC-V) reclassified hypertension stages, including stage 1.

Purpose of the Study:

  • To review the epidemiology, diagnosis, and treatment of hypertension.
  • To highlight the impact of concomitant risk factors and adherence issues.
  • To discuss JNC-V recommendations and pharmacologic agent choices.

Main Methods:

  • A comprehensive literature search was conducted using MEDLINE, dating back to 1986.
  • Key search terms included "hypertension," "antihypertensive agents," "patient compliance," "cardiovascular risk factors," "isolated systolic hypertension," and "JNC."

Related Experiment Videos

  • Additional references were identified through cross-referencing bibliographies.

    • Main Results:

    • Despite national efforts, 35% of hypertension cases remain undiagnosed, and only 7% are adequately controlled.
    • Cardiovascular risk factors significantly compound adverse outcomes and can be influenced by treatment.
    • JNC-V guidelines offer flexible but debated recommendations on equally effective pharmacologic agents.

    Conclusions:

    • Effective pharmacologic and non-pharmacologic management of hypertension can substantially reduce mortality.
    • Angiotensin-converting enzyme inhibitors, calcium channel blockers, alpha-blockers, and alpha-beta-blockers may offer superior cardioprotective effects compared to diuretics or beta-blockers.
    • Improving patient adherence through practical techniques, initiated at diagnosis, is crucial for effective hypertension management.